NPTE Test Questions Practice, Questions with accurate answers, rated A+. 2022

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NPTE Test Questions Practice, Questions with accurate answers, rated A+. 2022 What conditions are the abnormal heart sounds S3 and S4 associated with, respectively? A. S3 = MI or HTN; S4 =CH... F B. S3 = Tracheal Stenosis; S4 = Asthma C. S3 = closure of Mitral and Tricuspid Valves; S4 = Closure of Pulmonary Valves D. S3 = CHF; S4 =MI or HTN - ✔✔Feedback Correct Answer - D S3 is heard in early diastole (after S2) and is associated with CHF. S4 is heard in late diastole (before S1) and is associated with an MI or hypertension. A chronic smoker diagnosed with COPD was tested for an arterial blood gas (ABG) analysis. After reviewing the patient's chart, the physical therapist is MOST likely to see which of the following changes in the ABG results? A. Decreased PaCO2, increased PaO2, and decreased pH. B. Decreased PaCO2, decreased PaO2, and increased pH. C. Increased PaCO2, increased PaO2, and increased pH. D. Increased PaCO2, decreased PaO2, and decreased pH - ✔✔Feedback Correct Answer - D COPD causes dilation and destruction of the airspaces and alteration in pulmonary vasculature resulting in mismatch in ventilation in the alveoli and perfusion in the capillary membrane. This results in hypoxemia (decreased oxygen in the arterial blood) in the early stage of COPD and hypercapnea (increased carbon dioxide in the arterial blood) as the disease progresses. A geriatric patient recently developed CHF. The patient has symptoms of nausea, vomiting, and gastrointestinal irritability. The patient also presents with mental confusion and frustration. Based on these symptoms, what clinical condition does the therapist suspect? A. Alzheimer's disease B. Dementia C. Digoxin toxicity D. Age related symptoms - ✔✔Feedback Correct Answer - C Signs of digoxin toxicity in patients with CHF : Nausea, vomiting, headache, dizziness, confusion, abdominal pain, delirium, vision disturbance. With Alzheimer's and dementia, patient will experience significant memory loss. A patient has a history of diabetes, hypertension, and chronic heart failure. The patient's venous filling time is 10 seconds, while Homan's sign and rubor dependency tests are both negative. These findings support which of the following diagnoses? Select one: A. Chronic venous insufficiency B. Intermittent claudication C. Arterial insufficiency D. Lymphedema Feedback - ✔✔Correct Answer - A Venous filling time- The extremity is elevated and then lowered into a dependent position. The time it takes for the veins on top of the foot to refill is recorded. Normal filling time is 15 seconds. Greater than 15 seconds indicates arterial disease whereas less than 15 indicate venous disease. Rubor dependency test is negative indicating no arterial insufficiency. No signs of intermittent claudication and lymphedema are seen. While evaluating a 30-year-old male with shoulder pain, the therapist applies pressure at the end range of shoulder abduction and external rotation. The patient feels a sudden PARALYZING pain and WEAKNESS in his shoulder. This finding is MOST LIKELY an indication of: A. Thoracic outlet syndrome B. Myotome involvement C. Anterior instability D. Cervical spondylosis - ✔✔Feedback Correct Answer - C The therapist is performing anterior apprehension test or crank test. This test is primarily designed to check for traumatic instability problems causing gross or anatomical instability of the shoulder; positive anterior apprehension test indicates anterior instability. A physical therapist is examining a patient with hypomobile talocrural joint and finds that the range of motion of ankle dorsiflexion is limited. Which of the following mobilization techniques can be used to increase ankle dorsiflexion? A. Posterior glide of talus with small amplitude oscillations into tissue resistance at the limit of available joint motion B. Anterior glide of talus with small-amplitude rhythmic oscillations performed at the beginning of the range C. Posterior glide of talus with small-amplitude rhythmic oscillations performed at the beginning of the range D. Anterior glide of talus with small amplitude oscillations into tissue resistance at the limit of available joint motion - ✔✔Feedback Correct Answer - A Posterior glide of talus with small amplitude oscillations into tissue resistance at the limit of available joint motion At the talocrural joint, convex talus moves over with the concave mortise made up of the tibia and fibula. So, according to convex-concave rule, posterior glide of talus can be used to increase ankle dorsiflexion. Grade I, i.e. small-amplitude rhythmic oscillations performed at the beginning of the range is primarily used for treating joints limited by pain or muscle guarding. Grade IV, i.e. small-amplitude rhythmic oscillations performed at the limit of the available motion and stressed into the tissue resistance is used as stretching maneuver to increase range of motion. So, grade 4 and posterior glide of talus will be the most appropriate mobilization techniques for the patient. A therapist is examining a patient's straight leg raise by taking their leg into hip flexion, knee extension and ankle dorsiflexion with inversion. Which nerve is MOST likely being biased in this position? A. Common peroneal nerve B. Tibial nerve C. Sciatic and Tibial nerve D. Sural nerve Feedback - ✔✔Feedback Correct Answer - D Ankle Dorsiflexion with inversion places tension on the sural nerve. Plantar flexion and inversion places tension on the common peroneal nerve. Dorsiflexion and eversion with toe extension places tension on the tibial nerve. A physical therapist is assessing muscle strength of a 20-year-old male who reports having shoulder pain ever since he started lifting weights at the gym as part of his New Year's resolution. The therapist positions the patient in the supine position with 120° of shoulder abduction and moves the shoulder diagonally down and inward towards the patient's opposite hip. Resistance is given above the wrist in an up and outward direction. Which muscle is being tested? A. Pectoralis major clavicular head B. Pectoralis major both heads C. Pectoralis major sternal head D. Pectoralis minor - ✔✔Feedback Correct Answer - C MMT of Pectoralis major sternal head - the motion begins at 120° of shoulder abduction and moves diagonally down and in toward the patient's opposite hip. Resistance is given above the wrist in an up and outward direction. During a gait training session, a PT notices that the patient is beginning to lose balance in the anterior direction. What IMMEDIATE action should the therapist take? A. Pull the patient backwards B. Allow the patient to re-gain their balance C. Bring the patient to one knee D. Push the patient forward - ✔✔Feedback Correct Answer - A As the patient is beginning to lose the balance forward; pulling the patient backwards will help him to regain balance by performing a posterior weight shift. This is easiest to accomplish when assisted by the therapist. While evaluating the gait of a patient with right hemiplegia, the PT notes foot drop during mid-swing of the right leg. The MOST LIKELY cause of this deviation is: A. Inadequate contraction of the ankle dorsiflexors B. Excessive extensor synergy C. Decreased proprioception of foot-ankle muscles D. Excessive flexor synergy - ✔✔Feedback Correct Answer - A Ankle remains plantar flexed during swing and can be associated with dragging of the toes, typically called drop foot. It is caused by weakness or paralysis of foot dorsiflexors. Excessive extensor synergy causes tight plantar flexors. Excessive flexor synergy causes excessive dorsiflexion. Decreased proprioception does not cause foot drop. It causes sensory ataxia causing foot stomping gait. Which of the following is the MOST appropriate long-term goal for a PT to address in a patient with Down syndrome? A. Accelerate the rate of motor skills development B. Strengthen weak muscles C. Minimize the development of compensatory movement patterns D. Focus on rhythmic stabilization exercises - ✔✔Feedback Correct Answer - C In Down Syndrome, it is important to address the development of compensatory movement pattern, as it can further exacerbate hypotonicity. While rhythmic stabilization exercises do support the above, they are not a viable goal, but rather an activity. When examining a patient with a stroke, a physical therapist finds the patient's speech to be slow and hesitant. The patient is limited to one- or two-word responses but appears to fully comprehend sentences. Which of the following is the BEST description of the patient's ability to communicate? A. Global aphasia B. Non-expressive aphasia C. Wernicke's aphasia D. Broca's aphasia - ✔✔Feedback Correct Answer - D Broca's aphasia (nonfluent) is caused due to lesion involving third frontal convolution of the left hemisphere. The flow of speech is slow and hesitant, vocabulary is limited, and syntax is impaired. Speech production is labored or lost completely whereas comprehension is good. In Wernicke's aphasia speech flows smoothly with a variety of grammatical constructions but auditory comprehension is impaired. Global aphasia is severe aphasia with marked dysfunction across all language modalities and with severely limited residual use of all communication modes for oral-aural interactions. An elderly gentleman was admitted to the hospital with a stroke 2 days ago. The physical therapist has assessed the patient's functional strength, sensation, and bed mobility. With the patient seated at the edge of bed, the therapist instructs the patient to touch his nose with his index finger. The patient first flexes the elbow, and then adjusts the position of the wrist and fingers. The patient then further flexes the elbow, and lastly flexes the shoulder to generate contact between the index finger and the nose. What neurological impairment does the patient MOST likely have? A. Dysdiadochokinesia B. Titubation C. Dyssynergia D. Rebound phenomenon - ✔✔Feedback Correct Answer - C Dyssynergia is a manifestation of cerebellar pathology where the movement is performed in a sequence of component parts rather than as a single, smooth activity. A physical therapist is treating a patient status post a cerebrovascular accident. The patient is struggling to successfully clear his airway. Which of the following interventions should the therapist use? A. Coughing B. Incentive spirometer C. Postural drainage D. Huffing Feedback - ✔✔Correct Answer - D Huffing is a safe and effective technique for airway clearance. In huffing, abdominals are pulled up and in, rather than pushed out, causing decreased pressure in the abdominal cavity. Incentive spirometry is used to increase the inspiratory capacity. A patient diagnosed with Ménière's disease presents with vertigo. Which sign and symptom is LEAST consistent with the condition? A. Hearing loss B. Head tilt to one side C. Vertigo lasting 30 minutes D. Tinnitus Feedback - ✔✔Feedback Correct Answer - B Meniere's disease is a recurrent and usually progressive vestibular disease. It is associated with low frequency hearing loss, episodic vertigo. The patient may also complain of a sense of fullness and tinnitus. Head tilt to one side is not seen with Meniere's disease but seen with UVH. A 40-year-old male is a principal at a local high school, and was admitted to the hospital 1 week ago. During this time he had multiple complications including septic shock, decreased kidney function, and ultimately a great toe amputation to his right foot. The patient now presents with a warm, red, and edematous right lower limb. The MOST likely diagnosis is? A. Herpes zoster B. Dermatitis C. Cellulitis D. Impetigo - ✔✔Feedback Correct Answer - C Cellulitis is a painful infection of the soft tissue that is characterized by expanding local erythema, palpable lymph nodes, fever, and chills. Skin is hot, red and edematous. Most cases are caused by cuts, abrasions, insect bites, and local burns. Impetigo is superficial skin infection associated with inflammation, itching and small pus filled vesicles. Dermatitis is itching, inflammation of the skin. Herpes Zoster is pain, tingling over the spinal or cranial nerve dermatome and red papules, vesicle along its course. A female patient comes to the clinic complaining of loss of urine during activities such as sneezing, coughing, or laughing. Upon examination the physical therapist notices weakness in core and pelvic floor musculature. What is the MOST likely condition associated with these symptoms and findings? A. Urge incontinence B. Stress incontinence C. Overflow incontinence D. Flaccid bladder - ✔✔Feedback Correct Answer - B Urinary incontinence is the involuntary leakage of urine. Stress incontinence occurs when the support for the bladder or urethra is weak or damaged, but the bladder itself is normal. With stress incontinence, pressure applied to the bladder from coughing, sneezing, laughing, lifting, exercising, or other physical exertion increases abdominal pressure, and the pelvic floor musculature cannot counteract the urethral/ bladder pressure. Urge incontinence, is the involuntary contraction of the detrusor muscle with a strong desire to void and loss of urine as soon as the urge is felt. Overflow incontinence is over distention of the bladder and the bladder cannot empty completely. Urine leaks or dribbles out so the client does not have any sensation of fullness or emptying. A PT is assessing a patient's lymph nodes 6 months post-chemotherapy treatment. When assessing the lymph nodes, which presentation LEAST likely requires referral to a physician? A. Hard and fixed lymph node B. Rubbery or firm lymph node C. Soft and non-palpable D. Palpable lymph node - ✔✔Feedback Correct Answer - C Lymph nodes up to 1 cm in diameter of soft-to-firm consistency that move freely and easily without tenderness are considered within normal limits. Lymph nodes more than 1 cm in diameter that are firm and rubbery in consistency or tender are considered suspicious. Enlarged lymph nodes associated with infection are more likely to be tender, soft, and movable than slow-growing nodes associated with cancer. A 30-year-old male presents with atrophy of the intrinsic hand musculature, drooping of the eyelids, sunken eyeballs, lack of sweating and pupil constriction. Patient complaints include sudden pleuritic pain and a hoarse voice. What clinical condition is MOST likely related to these findings? A. Thoracic outlet syndrome B. Rib fracture C. Cervical myelopathy D. Pancoast tumor - ✔✔Feedback Correct Answer - D A growing Pancoast tumor can cause compression paravertebral sympathetic nerves leading to Horner's syndrome (drooping eyelid, lack of sweating, pupil constriction), compression of recurrent laryngeal nerve causing hoarseness of voice, compression of brachial plexus causing atrophy and weakness of muscles of arm and hand. TOS, rib fracture and cervical myelopathy will not cause Horner's syndrome. A patient fails to attain established physical therapy goals within the number of visits initially set by the physical therapist. The patient has made substantial progress in therapy, however has plateaued over the last 4 sessions. The most appropriate action for the physical therapist is? A. Request additional visits from the referring physician B. Document a progress note that updates the patient's current status C. Talk to the patient regarding their compliance D. Discharge the patient from physical therapy with a home exercise program - ✔✔Feedback Correct Answer - D With the patient's status plateauing, the therapist can no longer document that the patient's treatment is medically necessary. For this reason, it is best to discharge the patient with a home exercise program. A physical therapy student is planning to collect data on the effects of an electrical stimulation program on scapular dynamics in an asymptomatic population. The student will measure the distance between the spinous process to the inferior scapular angle at 0, 30, 60 and 100 degrees of shoulder abduction at three different time points. One of the MOST important factors for the success of this study is: A. Face validity B. Intra-rater reliability C. Inter-rater reliability D. Predictive validity - ✔✔Feedback Correct Answer - B Consistency of repeated measures performed by one individual is referred intrarater reliability. Here, one student will measure the distance multiple times; hence intra rater reliability is most important. For interrater reliability more than one tester must be present. Face validity is an assumption of validity based on the appearance of an instrument. Predictive validity is the degree to which a test is used to predict future outcome. A 27-year-old girl had a flip phone for the past 4 years and finally upgraded to an iphone 8. She has been on her new phone constantly and is now having difficulty swiping upwards with her thumb. She explains this to her friend who is a PT student. To improve her thumb's range of motion without difficulty, what is the BEST mobilization or glide the PT student should perform? A. Inferior glide B. Superior glide C. Ulnar glide D. Radial glide - ✔✔Correct Answer - D Radial glide is used to improve thumb extension. At the CMC joint, the trapezium is convex and the proximal metacarpal is concave for flexion and extension. Flexion and Extension are frontal plane movements of the thumb and concave metacarpal moves over the convex trapezium so glide will be in the same direction. (Concave-convex rule) A patient has a fracture of mid-shaft of humerus after falling on an outstretched hand. Which of the following nerves is most likely to be affected with this type of injury? A. Radial nerve B. Axillary nerve C. Median nerve D. Posterior interosseous nerve - ✔✔Correct Answer: Radial nerve The radial nerve can be injured if there is a fracture of the shaft of the humerus. The nerve may be damaged as it winds around behind the humerus in the radial groove and injury may occur at the time of the fracture, or the nerve may get caught in the callus of fracture healing. Axillary nerve can be injured with fracture of surgical neck of humerus. Most common causes of injury to median nerve are impingement in hypertrophied pronator teres and compression in carpal tunnel. Ms. Mary is a 71-year-old retired physical therapist who presents with an 18-month history of left lateral thigh and chronic low back pain. Her pain is described as dull, and is exacerbated by prolonged walking, stair climbing, getting out of a car, and lying in bed. The pain occasionally radiates to the lateral left knee and limits her walking ability. There is moderate-severe pain elicited during palpation over the left trochanteric bursa and tensor fascia lata. Which condition BEST supports the objective findings? A. Peripheral vascular disease B. Hip-Spine syndrome (OA hip & degenerative stenosis of lumbar spine) C. Greater trochanteric syndrome D. Degenerative lumbar spinal stenosis - ✔✔Correct Answer - C Greater Trochanteric Pain Syndrome (GTPS) involves the tendons and bursae surrounding the greater trochanter. An injury to these structures causes pain on the outside of buttock and thigh. Symptoms include pain over the outside part of the upper leg, from the hip to the knee along the thigh that's worse with activities such as standing, walking, or running. There is no neurological involvement like that in stenosis. For PVD pain does not increase upon palpation. While under the oversight of a PT, a patient performs a neurodynamic mobility exercise to reduce neural tension in the upper extremity. Following the therapy session, the patient calls the clinic to report increased neural symptoms with prolonged paresthesias. The MOST appropriate response by the physical therapist during the next session would be to: A. Explain that this sensation is normal and continue working in the same range B. Refer the patient back to the orthopedic physician C. Explain to the patient that this sensation is abnormal and decrease the range used D. Re-evaluate the patient and determine if there is a different source of their pain - ✔✔Correct Answer - C When performing neuromobilization, increased symptoms should be accounted for by decreasing the range that the exercises are performed in. The therapist would aggravate the patient's symptoms if the same range was utilized. No further medical action is necessary at this time. A 34-year-old male with excessive lordosis often complains of having a "weak" back. He states that he has an aching pain in his low back, and is unable to lift heavy objects without pain. You tell him that the reason his back feels weak is because of faulty alignment. What is the MOST appropriate primary intervention to correct this problem? A. Strengthen the lower back extensors B. Anterior pelvic tilt exercises C. Use a back support in the form of a corset or brace D. Strengthen the abdominal muscles - ✔✔Correct Answer - D An excessive lordosis may result in the pelvic crossed syndrome. In this syndrome, the erector spinae and the iliopsoas are found to be adaptively shortened, and the abdominal and gluteus maximus muscles are found to be weak. Strengthening exercises for the abdominal muscles & gluteal muscles and stretching of hip flexors and back extensors can help in reducing the lordosis. An 85 year old patient was admitted to the hospital following a diagnosis of dehydration. The medical history of the patient indicates chronic congestive heart failure. The most appropriate plan of respiratory care for the patient is: A. Deep breathing exercises, coughing and turning, every 2 hours B. Vigorous percussion and vibration 4 times per day C. Postural drainage with gentle vibration, with the foot of the bed elevated, twice a day D. Postural drainage using standardized positions, twice a day - ✔✔Correct Answer - A The patient has congestive heart failure so foot end elevation and standard postural drainage positions are contraindicated. Vigorous percussion and vibration is also not advisable. Turning, coughing and deep breathing every 1-2 hours is the best prophylactic treatment. Strengthening exercise is contraindicated in the presence of any of the following laboratory test results EXCEPT: A. 20% Hematocrit B. Prothrombin time of 12 seconds C. Platelet count of 50,000 cells/mm3 D. INR - 3 - ✔✔Correct Answer - B Normal prothrombin time is 11-15 seconds, so 12 secs is normal and strengthening exercise should not be contraindicated. Normal INR value is 0.9-1.1, so with INR 3 strengthening exercises will be contraindicated. Normal hematocrit level is 37-52%, so for 20% hematocrit strengthening exercise will be contraindicated. Normal platelet value is 150,000-400,000/mm3, so with 50,000/mm3 platelets strengthening exercise will be contraindicated The shoulder is the most mobile joint in the body, but because of its wide range of movements it is one of the most commonly injured. Which of the following is the MOST commonly dislocated joint in the shoulder? A. Acromioclavicular joint B. Sternoclavicular joint C. Scapulothoracic joint D. Glenohumeral joint - ✔✔Correct Answer - D Glenohumeral joint is the most mobile joint. It is a multiaxial, ball-and-socket, synovial joint that depends primarily on the muscles and ligaments rather than bones for its support, stability. It has high mobility but little articular stability making it the most commonly dislocated joint of the shoulder complex. A patient was recently discharged from the hospital following 12 weeks of rehabilitation for a complete spinal cord injury at T10. Which of the following equipment/assistive devices would be MOST essential to assist the patient with functional mobility given the patient's level of injury? A. Ambulation with lofstrand crutches B. Ambulation with lofstrand crutches and AFO C. Ambulation with lofstrand crutches and KAFO D. Wheelchair - ✔✔Correct Answer - D At T10 spinal cord injury level, lower limb muscles are not innervated thus the patient requires wheelchair for functional mobility. At this level, the patient is independent with manual wheelchair in home and community. To ambulate for functional mobility the level of injury should be at least L3 or below. A PT Assistant was treating a patient status post ACL reconstruction and asked the patient to complete knee extension exercises that were not in the original plan of care. After completing the exercises, the patient's pain was exacerbated and later determined that they were injured during the PTA's care. In this scenario, who is MOST responsible for the patient's injury? A. The primary physical therapist B. The treating physical therapy assistant C. The PT Aide in the clinic D. The PT Student who observed the situation - ✔✔Correct Answer - B PT assistant is responsible for his own action as performing exercises under the original plan of care comes under professional responsibilities of PTA. Which of the following treatment guidelines is LEAST effective for patients with Alzheimer's disease? A. Group therapy with exercises that use verbal commands B. Exercises should be short and simple and done in the same order each day C. Group therapy with exercises that that use images D. Exercise program should include group interaction with physical touching such as holding hands or working in pairs - ✔✔Correct Answer - A It is difficult for Alzheimer's patient to follow and remember verbal commands, so option A is least effective. Using images, short, simple and same exercises every day is beneficial for the patient. All of the following are absolute contraindications for exercise during pregnancy EXCEPT: A. Restrictive lung disease B. Preeclampsia C. Severe Anemia D. Chronic bronchitis - ✔✔Correct Answer: Chronic bronchitis The woman with chronic bronchitis may participate in an exercise program under close observation by a physician and a therapist as long as no further complications arise. Exercises often require modification which should be discussed with the referring practitioner. Restrictive lung disease, preeclampsia and severe anemia are absolute contraindications to exercise during pregnancy. Mr. Stewart is a 74-year-old retired contractor. He came to physical therapy with complaints of chronic left lower back pain. Upon watching him walk to the treatment room, he has a prominent backward lean during stance phase of the left leg. From this observation, you hypothesize that the MOST likely cause of his gait deviation is: A. Weak hip extensors on the left B. Weak hip flexors on the left C. Weak hip extensors on the right D. Weak hip flexors on the right - ✔✔Correct Answer - A Weak hip extensors cause backward lean in stance phase on the weaker side (left in this case). The backward lean moves the line of gravity behind the hip and reduces the need for hip extension torque. Weak hip flexors cause limited hip flexion on the affected side. A physical therapist performs the slump test on a patient with diagnosed L4 disc herniation. Which of the following is the MOST important key indicator of a positive result? A. Pain in the low back area that increases with lumbar flexion B. Pain in the buttocks that is unchanged with head or ankle movement C. Pain in the posterior leg and calf that is relieved with cervical extension D. Pain in the lateral foot and calf that is relieved with ankle plantarflexion - ✔✔Correct Answer - C The slump test is considered positive if the positioning (spinal flexion, knee extension and dorsiflexion) of the patient increases the symptoms or if the symptoms decrease with neck extension. A 30-year-old female presents to a PT clinic with complaints of pain on the anterior aspect of her elbow and the palmar side of the first, second, third, and half of the fourth digits. What clinical condition below is MOST likely causing these symptoms? A. Carpal tunnel syndrome B. Pronator teres syndrome C. Wartenberg's syndrome D. Arcade of Frohse syndrome - ✔✔Correct Answer - B Pronator teres syndrome is a compression neuropathy of the median nerve at the elbow between the two heads of pronator teres. It can lead to pain and numbness in the distribution of the distal median nerve (index finger, long finger, and radial side of ring finger) and weakness can develop in median-innervated muscles. Symptoms also include tenderness over pronator teres muscle at the anterior aspect of the elbow. Nocturnal pain and tinel's sign at wrist is positive for carpal tunnel syndrome. Wartenberg's syndrome is described as the entrapment of the superficial branch of the radial nerve with only sensory manifestations and no motor deficits. To prevent maximal compressive force being placed on the patella, a therapist should avoid placing a patient in what position? A. Prone with the knee flexed to 30 degrees B. Seated with the knee flexed to 90 degrees C. Supine with the hip and knee flexed to 110 degrees D. Prone with the knee flexed to 110 degrees and the hip in slight extension - ✔✔Correct Answer - D Positioning the patient in prone places the hip into an extended position. From this position, increasing knee flexion to 110 degrees results in passive insufficiency of the quadriceps, which creates higher compression at the patella. Since the quadriceps group is aligned anatomically with the shaft of the femur and not with the mechanical axis of the lower extremity, any quadriceps muscle contraction (regardless of knee flexion angle) results in compressive forces acting on the patellofemoral joint A physical therapist is treating a patient who has severe cognitive impairments and bilateral hip and knee flexion contractures. The MOST appropriate intervention to treat the patient's contractures is: A. Agonistic reversals B. Prolonged stretching C. Contract-relax technique. D. Alternating isometrics - ✔✔Correct Answer - B Prolonged stretching - it will help in stretching the contracture, as in this procedure soft tissues are elongated just past the point of tissue resistance and then held in the lengthened position with a sustained stretch force over a period of time. Also, the patient is cognitively impaired; it will not be possible for the patient to follow commands. An important requirement for PNF stretching techniques is the normal innervation and voluntary control of the muscles. During a postural screen on a patient with chronic shoulder pain, a therapist observes excessive internal rotation of the shoulders and winging of the scapulae during overhead motions. The MOST appropriate interventions to address these problems should include: A. Strengthening of pectoral muscles and stretching of upper trapezius B. Strengthening of upper trapezius and stretching of pectoral muscle C. Strengthening of serratus anterior and stretching of pectoral muscles D. Strengthening of rhomboids and stretching of upper trapezius Feedback - ✔✔Correct Answer - C Weakness of serratus anterior causes winging of scapula. Excessive internal rotation of humerus is caused by tightness of pectoral muscles. Thus, strengthening of weak muscles (serratus anterior) and stretching of tight muscle (pectorals) is the intervention. A patient is demonstrating an upper extremity flexion synergy following a CVA. Which of the following is MOST likely associated with this type of synergy? A. Scapular retraction B. Elbow extension C. Wrist extension D. Forearm pronation - ✔✔Correct Answer - A Upper extremity flexion synergy components are scapular retraction/elevation, shoulder abduction and external rotation, elbow flexion, forearm supination, wrist and finger flexion. B & D are components of extension synergy. During your nerve examination of extraocular muscle function, you note that your patient has vertical nystagmus during smooth pursuits. The MOST likely diagnosis for this condition is: A. Lesion of optic nerve B. Posterior canal BPPV C. Acoustic neuroma D. Central nervous system lesion - ✔✔Correct Answer - D In central nervous system pathology vertical and pendular nystagmus is observed. In peripheral vestibular system pathology horizontal nystagmus is observed. A 2-year-old sustains superficial partial-thickness burns in a house fire. The child's anterior legs, face, chest, and abdomen are covered with burns. The approximate surface area that is burned is: A. 79% B. 39.5% C. 48% D. 61% - ✔✔Correct Answer - B Rule of Nines can be used to determine the percentage of body surface area burn in children. Calculation-Legs (6.5+6.5) + chest & abdomen (18) + face (8.5) = 39.5% Which one of the following sympathetic cardiovascular changes occurs in a patient with long-standing type 1 diabetes mellitus? A. HR becomes fixed B. Higher resting HR C. Lower resting HR D. Exercise increases HR - ✔✔Correct Answer - A Long term complication of Type 1 diabetes mellitus is cardiac denervation syndrome which results in a fixed HR that is unresponsive to exercise, stress or sleep. A patient referred for vestibular rehab presents with oscillopsia, a loss of gaze stabilization, and spontaneous nystagmus that can be suppressed with visual fixation. Additional problems include disequilibrium and ataxic gait pattern with consistent veering to the left. Based on these findings, the patient is MOST likely to have which condition? A. BPPV B. Acute UVH C. Acoustic neuroma D. Meniere's disease - ✔✔Correct Answer - B Symptoms of UVH - resting (spontaneous) nystagmus, oscillopsia, dysequilibrium, postural instability. BPPV is a disorder arising from a problem in the inner ear. Symptoms of BPPV include nystagmus, vertigo with change in head position, and occasionally nausea with or without vomiting, and dysequilibrium. Each episode of vertigo typically lasts less than one minute. Meniere's disease is a recurrent and usually progressive vestibular disease. It is associated with tinnitus, deafness, sensation of fullness in the ear and vertigo A patient has been admitted to the hospital after a fall. While examining the patient, the physical therapist noticed bilateral lower extremity edema. What does the physical therapist suspect due to the clinical findings? A. Varicose veins B. Lymphedema C. Thrombophlebitis D. CHF - ✔✔Correct Answer - D Proper functioning of heart depends on both ventricles; failure of one ventricle almost always leads to failure of the other ventricle. This is called ventricular interdependence. With RV failure, blood is not effectively ejected from the RV and backs up into the RA and venous vasculature, producing peripheral edema. Varicose veins are gnarled, enlarged veins, most commonly appearing in the legs and feet. Lymphedema is a chronic disorder characterized by an abnormal accumulation of lymph fluid in the tissues of one or more body regions. Thrombophlebitis is clot formation and inflammation in a vein. A 65-year-old, morbidly obese male patient is admitted in ICU from last three weeks with diagnosis of heart failure. The physical therapist working in the ICU unit observes new symptoms of mild pain, warmth and swelling over the posterior aspect of left calf of the patient. The therapist shares the findings with the physician, who initiates the drug therapy. Which of the following drugs should be added in the treatment of this patient? A. Diazepam B. Nitroglycerin C. Heparin D. Lipitor - ✔✔Correct Answer - C Deep venous thrombosis is potential complication for all immobilized patients. The most common symptoms of DVT are pain in the region of the thrombus and unilateral swelling distal to the site, redness or warmth, dilated veins, or low-grade fever. Anticoagulation, such as heparin can be used in the treatment of individuals at risk for or diagnosed with a DVT. Nitrates, such as nitroglycerin dilate the coronary arteries and are used to prevent or relieve the symptoms of angina. Diazepam is used to relax skeletal muscle and decrease muscle spasm. Lipitor is an anti-cholesterol agent used in the management of hypercholesterolemia and mixed dyslipidemias. A patient is admitted to a hospital for a left femur fracture after a recent fall at home. A review of the patient's medical chart reveals blood pressure (BP) of 165/90, triglyceride level of 160 mg/dL, and a fasting blood glucose level of 115 mg/dL. The patient's BMI is 40 kg/m2 with a 54-inch waistline. These findings are MOST consistent with a medical diagnosis of: A. Chronic heart disease. B. Type 2 diabetes C. Metabolic syndrome D. Cushing's syndrome - ✔✔Correct Answer - C The metabolic syndrome is characterized by a group of metabolic risk factors in one person. The risk of serious illness increases in anyone with three or more of the following factors: waist size of more than 40 inches in male, more than 35 inches in female, Triglycerides>150mg/dl, elevated blood pressure (130/85 mm Hg or more), fasting blood sugar>100 mg/dl, HDL cholesterol less than 50 mg/dL for woman and less than 40 mg/dL for man. A college student presents with complaints of right-sided neck pain. During the AROM examination, the physical therapist observes the following osteokinematic neck motions: full side-bending left, full rotation to the left, full forward flexion, limited and painful extension, limited and painful right side-bending, and limited and painful right rotation. Based on this pattern, what is the MOST likely arthrokinematic restriction? A. Restriction with downglide of a facet on the right B. Restriction with upglide of a facet on the right C. Restriction with downglide of a facet on the left D. Restriction with upglide of a facet on the left - ✔✔Correct Answer - A In the cervical spine, rotation and side bending occur to the same side (except C1-2). With extension limited, the most likely restriction is a downglide. With right rotation, and right side bending, the right cervical facets would be going into a downglide. If this motion is limited, then restriction of downglide with facet on the right is the most likely problem. A patient with a history of diabetes comes to the clinic with reports of ankle dorsiflexion weakness and diminished sensation over the anterior leg and dorsum of the foot. What is the MOST likely diagnosis? A. Common peroneal nerve lesion B. Saphenous branch of femoral nerve lesion C. Tibial nerve lesion D. Posterior cutaneous branch lesion - ✔✔Correct Answer - A Common peroneal nerve innervates the dorsiflexor muscles and sensation on anterior aspect of leg. Saphenous nerve (branch of femoral nerve) and posterior cutaneous nerve are sensory nerves with no motor function. Tibial nerve supplies the plantarflexor muscles and sensation on posterior aspect of leg and sole of foot. An adolescent female patient is diagnosed with right thoracic scoliosis with a 52 degree curvature. Which of the following is MOST likely a true statement based on the patient's diagnosis? A. The patient's thoracic vertebral bodies and spinous processes are rotated to the left B. The patient's right-side thoracic transverse processes are rotated anteriorly, carrying the ribs with them C. The patient's left-side thoracic transverse processes are rotated posteriorly D. In neutral standing posture, the patient has a left lateral flexion bias of the thoracic spine - ✔✔Correct Answer - D Scoliosis is a deformity in which there are one or more lateral curvatures of the lumbar or thoracic spine Right thoracic scoliosis will have left lateral flexion (concave) and convexity towards right side. The rotation of vertebra, scapular prominence and rib hump is on the right side (convex) and the rotation of spinous process is towards the left side (concave /hollow). A PT is consulted to evaluate a patient in an acute care hospital. The patient has symptoms of muscle aches, cramps, soreness and weakness in a proximal to distal pattern in bilateral lower extremities. The patient mentions that his urine has been tea colored recently. The patient's lab report from the previous day indicates a creatine kinase level more than 10 times the upper limit of normal. Which of the following is MOST consistent with these clinical findings? A. Hyponatremia B. Hypokalemia C. Rhabdomyolysis D. Myasthenia gravis - ✔✔Correct Answer - C Rhabdomyolysis is a potentially fatal condition is which myoglobin and other muscle tissue contents are released into the bloodstream as a result of muscle tissue disintegration. This could occur with acute trauma, severe burns, overexertion, from alcohol abuse or alcohol poisoning or with statins. It leads to muscle aches, cramps, weakness and soreness. Dark color of urine is due to liver failure. Hyponatremia is low level of sodium in the blood symptoms include nausea, headache, confusion, and fatigue. Hypokalemia is low potassium levels in the blood. Symptoms may include feeling tired, leg cramps, weakness, constipation, abnormal heart rhythm. MG is characterized by muscle weakness including muscles of face, eyes, neck and does not depict change in urine color. A 70-year-old male patient presents to an outpatient clinic with sensory loss of the right face and arm. This patient is taking medications for hypertension, diabetes mellitus type 2, and hydrocortisone for a rash on his leg. The patient initially seems confused but otherwise has intact speech. The therapist would MOST likely suspect a lesion in which vessel? A. Left MCA superior division B. Left MCA inferior division C. Right MCA superior division D. Right MCA inferior division - ✔✔Correct Answer - B Infarct in middle cerebral artery inferior division causes contralateral homonymous hemianopia, fluent aphasia (Wernicke's area). Superior division MCA infarct is responsible for Brocas aphasia. A group of PT students are compiling an injury prevention program for adolescent soccer players. During their research, they maximize their time by collecting data on the SEBT, the Single Leg Hop Test, and the Single Leg Balance test. In order to have the MOST consistent data, which form of reliability is most important? A. Intrarater reliability B. Test re-test reliability C. Interrater reliabliity D. Criterion validity - ✔✔Correct Answer - C Interrater reliability - Consistency of scores between the raters must be established, since both therapists are collecting data on the same measurements. A physical therapist is performing cranial nerve testing on a 55-year-old male patient. When observing the patient's right papillary response to light, the physical therapist observes that there is no constriction of the right pupil but the left pupil does constrict. Which cranial nerve is the MOST likely cause of this impairment? Select one: A. Left Oculomotor nerve (CN III) B. Right Optic nerve (CN II) C. Right Oculomotor nerve (CN III) D. Left Trochlear nerve (CN IV) - ✔✔Correct Answer - C CN II is afferent and CN III is efferent component of pupillary reflex. Pupillary reaction (constriction) is tested by shining light in eye. When light is shown in the right eye, intact right CN II (optic) carries sensory information, which stimulates efferent CN III (occulomotor) to cause constriction of the pupil. As there is constriction of left pupil and no constriction of right pupil, it indicates that right CN III is affected. A physical therapist is treating a patient with Cerebral Palsy. The patient is seen in standing with a toe-in posture. Which of the following postural strategies correlates with the observed foot position? A. Metatarsus Adductus, internal Tibial torsion, increased femoral retroversion B. Metatarsus Adductus, internal Tibial torsion, increased femoral anteversion C. Metatarsal Adductus, external tibial torsion, increased femoral retroversion D. Metatarsal Abductus, external tibial torsion, increased femoral retroversion - ✔✔Correct Answer - B A position of toe-in would correlate with metatarsus adductus (forefoot adducted), internal tibial torsion (position of pronation), and increased femoral anteversion (associated with increased anterior pelvic tilt). A physical therapist notices a positive Stemmer's sign; this is indicative of what disorder? A. Dehydration B. Thromboangiitis obliterans C. Pulmonary embolism D. Lymphatic disease - ✔✔Correct answer is D. When the dorsal skin folds of the toes or fingers are resistant to lifting or cannot be lifted at all, the Stemmer's sign is said to be "present." It is an early indication of primary lymphedema. It is not seen with thromboanginitis obliterans, pulmonary embolism and dehydration. A patient that is eight days status post ACL reconstruction (patellar tendon autograft) is being examined by a physical therapist. What is the MOST appropriate exercise to implement into the patient's home exercise program? A. Leg press on operated side B. Mini squats C. Limited range isokinetic at 30 degrees D. Active knee extension in short sitting - ✔✔Correct Answer - B The patient is 8 days post ACL reconstruction, hence, partial wall squats is most appropriate as it causes minimum stress on the graft. The exercises options in A,C,D can create excessive stress on the graft and increase the chances of its rupture.- A PT is examining ULTT in a patient. He performs the test by placing elbow in extension, forearm in pronation, wrist in flexion and ulnar deviation, and shoulder in abduction. Which nerve is MOST likely to be tested based on the patient's positioning? Select one: A. Median Nerve B. Radial nerve C. Axillary nerve D. Ulnar nerve - ✔✔Correct Answer - B With the shoulder in abduction & internal rotation, elbow in extension, forearm in pronation, wrist in flexion and ulnar deviation, the radial nerve is placed under the most tension. An 85-year-old patient is admitted to the hospital for lung congestion. The patient's granddaughter (who is a physician from a different hospital) visits him in the hospital. She wants to look at her grandfather's medical record. The Physical Therapist should: A. Tell her to ask the consultant cardiologist for permission B. Tell her she cannot see the chart because she could misinterpret the information C. Tell her that she must have the permission of her grandfather before she can look at his chart D. Give her the chart and let her read it as she may have some insights - ✔✔Correct Answer - C According to HIPAA privacy rule - Written consent must be obtained from the patient before any of their health information is disclosed. Those involved in the patient care have access to the medical reports. A patient with lower back pain presents to the clinic. The patient is experiencing radicular symptoms down the left leg, crossing the front of the knee, and their pain becomes worse with repeated extension. Based on these symptoms, what is the MOST likely cause? A. L4 nerve root irritation B. L5 nerve root irritation C. Spinal stenosis D. Piriformis syndrome - ✔✔Correct Answer - A The location of the pain correlates with irritation of the L4 nerve root. Repeated extension would provoke irritation of a nerve root. A 30-year-old male patient presents with left lower abdominal pain, bloody stools, and flatulence. The "pinch-an-inch" test result is positive. Which condition is MOST related to the symptoms described? A. Appendicitis B. Diverticulitis C. Crohn's disease D. Irritable bowel syndrome - ✔✔Correct Answer - B Diverticulitis describes the infection and inflammation that accompany a microperforation of one of the diverticula. Symptoms include abdominal pain, low grade fever, nausea, change in bowel habits, left lower quadrant pain, bloody stool, and pinch-an-inch test may be positive at times. In appendicitis pinch-an-inch test may be positive but it is associated with right lower quadrant pain. A new patient comes to an outpatient clinic for aerobic conditioning and strengthening. The patient has an extensive cardiac history that requires him to take Beta-blockers. The physical therapist decides to start the patient off with treadmill training. What is the MOST important consideration for the therapist if the patient is on Beta-blockers? A. RPE scale will be the best tool to assess the patient's exertion level B. Call the physician to inform them that physical therapy is not indicated for this patient C. Patient's response to exercise should only be done by assessing blood pressure and pulse D. Tell the patient to take medicine immediately after exercising - ✔✔Correct Answer - A For patients on B-blockers HR cannot be relied on for evaluating exercise intensity as HR will not show increase with exercise. In these patients, RPE is best tool to increase the accuracy of monitoring and the prescription of exercise intensity. An 85-year-old female patient stays alone at home and spends the majority of her day lying in bed. During their examination, the physical therapist finds an ulcer as shown in the picture below. The BEST diagnosis for this wound is: Select one: A. An arterial ulcer B. Suspected deep tissue injury C. Stage III pressure ulcer D. Stage IV pressure ulcer - ✔✔Correct Answer - B The center of the ulcer is a localized area of deep purple tissue surrounded by non-blanchable redness indicating a deep tissue injury. In deep tissue injury, wound may present as a dark purple or blue hue with erythema or a blood-filled blister caused by damage of underlying soft tissue by pressure or a shear force. A physical therapist observes a patient's wheelchair footrests touching the ground. What is the MOST LIKELY cause? A. Depth of the chair is too high B. Depth of the chair is too low C. Leg length is too long D. Seat height is too low - ✔✔Correct Answer - D If the seat height is low, foot plate can touch the floor. Increased seat depth causes a kyphotic posture, sacral sitting and compromises circulation. Too low depth fails to support the thigh adequately and results in poor balance because of decrease in the base of support. Increased leg length encourages sacral sitting and forward sliding in the chair. During a cranial nerve examination, PT asks the patient to open his mouth. The PT notices that the patient's uvula is angled towards the right side. Which cranial nerve is most likely affected and which side is most likely weak? A. CN 10, Weak Left B. CN 10, Weak Right C. CN 9, Weak Left D. CN 12, Weak Right - ✔✔Correct Answer - A When cranial nerve X of left side is affected, it causes left side weakness and uvula deviates to the right side. Intact CN X (Vagus) maintains midline position of uvula, CN IX (glossopharyngeal) maintains the gag reflex. CN XII maintains position of the tongue. While working with a patient who has suffered CVA 6 weeks ago, a physical therapist chooses to promote recovery using NDT described by Bobath. Which technique is the therapist MOST likely to implement? A. Quick stretch to facilitate weak muscles B. Tactile cues to the pelvis and shoulders to control posture C. Constrain the uninvolved upper extremity and force the use of the involved extremity D. Perform progressive resistive exercises of bilateral upper extremities to increase muscle strength. - ✔✔Correct Answer - B NDT by Bobath is a problem solving and assessments approach. It plays an important role in movement patterns, postural control and directly affects the performance of functional task. Therapeutic handling is the main method for better functional and postural performances of task. Individuals are encouraged for active participation during treatment sessions. Also, functional training is emphasized for development. A 64-year-old female patient is experiencing difficulty breathing when she lies in her bed. She reports having a nonproductive cough, and lab values indicate pulmonary hypertension. All of these symptoms may indicate which of the following medical conditions? A. Aortic stenosis B. Mitral stenosis C. Cor pulmonale D. Left CHF - ✔✔Correct Answer - D Pathology of the left ventricular failure reduces the CO leading to a backup of fluid into the left atrium and lungs. The increased fluid in the lungs produces shortness of breath and cough. Persistent spasmodic cough, especially when lying down, occurs due to fluid movement from the extremities to the lungs. On examination, a 30-year-old female patient complains of pain during extension and rotation of the cervical spine. During the examination, the PT notes a positive Bacody's sign. This is MOST consistent with a diagnosis of: A. Brachial plexus lesion B. Peripheral nerve lesion C. Cervical radiculopathy D. Cervical myelopathy - ✔✔Correct Answer - C Bakody's sign, also known as shoulder abduction test is used to test for radicular symptoms, especially those involving the C4 or C5 nerve roots. A decrease in or relief of symptoms indicates a cervical extradural compression problem, such as a herniated disc, epidural vein compression, or nerve root compression. Abduction of the arm decreases the length of the neurological pathway and decreases the pressure on the lower nerve roots. A 24-year-old female is being evaluated for anterior knee pain. The patient walks without an assistive device and reports a dull constant pain when she is weight-bearing on the leg. She also has a history of multiple lateral ankle sprains from years of playing basketball. A clinical gait analysis reveals knee hyperextension during stance phase. The MOST LIKELY contributing factor to this gait presentation is: A. Soleus contracture retracting the tibia B. Contralateral abductor weakness causing a trunk lean C. Quadriceps contracture pulling the knee in hyperextension D. Degenerative joint changes causing a change in ground reaction forces - ✔✔Correct answer is A. Soleus muscle is a plantarflexor. Soleus contracture retracts the tibia, so, knee must hyperextend to compensate for the lack of forward displacement of the tibia during midstance. Degenerative changes and contralateral abductor weakness is less likely to demonstrate knee hyperextension. All of the options below are potential complications of obesity during exercise EXCEPT: A. Precipitation of angina pectoris or myocardial infarction B. Hyperhydration and increased circulating blood volume C. Ligamentous injuries D. Chafing - ✔✔Correct Answer - B Hyper hydration is not seen with obesity since obese people are susceptible to dehydration. They have increased heat intolerance as that they are less able to adapt to temperature changes, risk of hyperthermia and heat exhaustion. Which of the following findings is MOST common in patients with COPD? A. Dorsal Kyphosis B. Hemoptysis C. Cor pulmonale D. Decrease Respiratory rate - ✔✔Correct Answer - A COPD is characterized by airflow obstruction, air entrapment and pulmonary hyperinflation. In this, the thorax appears enlarged owing to loss of lung elastic recoil and hyperinflation. In COPD, the anterior-posterior diameter of the chest increases, resulting in dorsal kyphosis. Cor pulmonale occurs in later stages of COPD. Respiratory rate can be increased due to increased work of breathing. Hemoptysis occurs in some patients but dorsal kyphosis is the most common finding. Out of the following research questions, which one represents a qualitative research design? A. How many patient undergo lower limb amputations every year in the United States ? B. What are the experiences of patients with limb loss in returning to sports? C. What is the average length of patient stay in an acute care after undergoing a lower limb amputation? D. What is the percentage of lower limb amputees who achieve walking within 1 year after injury? - ✔✔Correct answer is B. In Qualitative research the data is non-numerical. Data is spoken words, experiences, surveys, interviews. It has a hypothesis and prediction about what will be the outcome. Conclusion is narrative, interpretative, based on people's views and opinions. Experience of patients is non numerical, hence qualitative research. For options A, C, & D the data is quantitative and numerical. A physical therapist is documenting their findings after examining a 30-year-old traumatic brain injury patient. Decorticate rigidity was noted in the motor changes of the patient. Which of the following description best explains the documented terminology? A. Flexion in all four limbs B. Upper limbs in extension and the lower limbs in flexion C. Upper limbs in flexion and the lower limbs in extension D. Extension in all four limbs - ✔✔Correct Answer: C The terms decorticate rigidity and decerebrate rigidity are often used to denote abnormal posturing in patients with severe brain injury. Decorticate rigidity refers to sustained contraction and posturing of the upper limbs in flexion and the lower limbs in extension. Decerebrate rigidity (abnormal extensor response) refers to sustained contraction and posturing of the trunk and limbs in a position of full extension. A physical therapist is performing cranial nerve testing on a 55-year-old male patient. The physical therapist gives the following command to the patient: "Close your eyes tightly and don't let me open them." Which of the following cranial nerves is being tested? A. Right Optic nerve (CN II) B. Oculomotor (CN III) C. Trochlear (CN IV) D. Facial (CN VII) - ✔✔Correct Answer - D Facial nerve (CN VII) is efferent for muscles of facial expression, e.g. closing the eyes tightly. Oculomotor and trochlear nerve are responsible for extraocular movements of the eye. Optic and oculomotor together are responsible for the pupillary reflex. Which functional task is MOST difficult for a patient with Adhesive Capsulitis to complete? A. Reaching objects on a high shelf B. Brushing the hair C. Reaching behind the back to fasten a bra D. Reaching out a car window to use an ATM machine - ✔✔Correct Answer - B In adhesive capsulitis, there is capsular pattern of restriction- lateral rotation> abduction>medial rotation. Combing hair requires external rotation and is thus most difficult to perform due to maximum restriction. Reaching objects on a high shelf needs flexion and abduction. Reaching out of a car window to use an ATM machine needs abduction. Reaching behind the back to fasten a bra needs internal rotation. A 30-year-old pregnant woman complains of low back pain and discomfort. Upon examination the physical therapist finds that right ASIS is higher than the left ASIS, and right PSIS is lower than the left PSIS. While performing the long sitting special test, the right limb is shorter in supine and appears to get longer in sitting. Based on the examination, what is the MOST appropriate treatment? A. Stretch the Right Hip Extensors B. Stretch the Right Hip Flexors C. Strengthen the Right Hip Flexors D. Strengthen the Right Hip Extensors - ✔✔Correct Answer - A The patient has right posterior innominate rotation i.e. PSIS is lower and the ASIS is higher on the involved side. It can be caused by tightness of right hip extensors. Hence, intervention is stretching tight hip extensors. Stretching the right hip flexors will increase right hip extensor tightness. A 33-year-old patient complains of a "creeping and crawling" sensation down her legs, accompanied by involuntary contractions of the calf muscles. These symptoms are increased at night. What condition below is MOST commonly related to these clinical findings? A. Vascular claudication B. Peripheral Neuropathy C. Neurogenic claudication D. Restless leg syndrome - ✔✔Correct Answer - D Restless leg syndrome causes sleep disturbances, paresthesia, and uncomfortable sensations (itchy, pins and needles, creepy, crawly). In vascular and neurological claudication, pain increases with exercise and not at night. A 55-year-old male has recently been diagnosed with single vessel coronary artery disease and is referred to cardiac rehabilitation. What is the MOST appropriate initial exercise prescription for this patient? A. 40% to 60% of maximum HR B. 65% to 75% of VO2 max C. Exercise 3 times a week for 20 to 40 minutes depending upon tolerance D. Exercise for 30 to 60 minutes depending upon tolerance - ✔✔Correct Answer - A Initial exercise intensity for the patient should be 40-60%HR max. Gradually increase the duration and frequency of exercise and then the intensity. 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